Medication Authorization Form

Before a student may receive, possess, or consume prescription or nonprescription medication, the student’s parents/guardians and physician must complete a Medication Authorization Form (link below) and have it on file in the health office at the child’s school. The form shall specify the appropriate dosage and times when the medication must be administered.

Medication Authorization Form

Asthma Guidelines

Recent legislation regarding asthma inhalers requires schools to allow full-time possession and self-administration of asthma medication by a student.

  1. The student’s parents or guardians provide the school with written authorization for the self-administration of the medicine.
  2. The parents or guardians of the student provide the school with the inhaler in the box with the prescription label affixed to it.
  3. The District is also requiring that the student MUST report to the health office each time after the inhaler is used.

The new statute allows the student to possess and use his/her asthma medication: while in school, while at school-sponsored activities, while under the supervision of school personnel, or before or after normal school activities such as before-school or after-school meals, study, daycare programs, etc.

Please complete the form below and return them to your student’s school.

Self-Administration of Asthma Medication Consent Form

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